APS111&113 - 2014 Client Statement

Strengthening the Cold Chain for Vaccinations

Equitable access to immunizations is one of the most successful and cost effective health treatments [1].
Through various World Health Organization (WHO) immunization programs diseases such as small pox
have been eradicated. To put that into perspective as recent as 1950s there were 50 million global
cases of small pox. Vaccination dropped that figure to 10-15 million by 1967 when the World Health
Organization undertook the worlds first global immunization push. By 1977 the last natural case of the
disease that had plagued humankind for thousands of years and killed as many as 10-15% of all infants,
was eradicated [2].
In May 2012 the World Health Assembly approved the Global Vaccination Action Plan (GVAP). The GVAP
would see universal access to vaccinations for every man, woman and child on the planet. The goal is to
expand the already 2.5 million lives saved each year by vaccinations by eradicating other vaccinepreventable deaths from diseases such as polio, diphtheria, tetanus, whooping cough, measles,
Haemophilus influenza type b disease, and epidemic meningococcal A meningitis [1].
A major obstacle in this goal is not the manufacture of the vaccines. The challenge actually lies in the
logistics, the supply chain that transports these vaccines from the manufacturer to the patient. This
supply chain is difficult since vaccines are highly temperature sensitive. If a vaccine falls below 2 C or
rises above 8 C, even for a short period of time, they may lose their viability [3]. This network of people,
processes and equipment that maintain this tight control over temperature is called the Cold Chain [4].
In the developed world, with ready access to electricity-fed cold storage and refrigerated transportation
vehicles, maintaining the Cold Chain is not difficult. In the developing world however, where access to
electricity can be unreliable or non-existent, maintaining the Cold Chain is a daunting task [4].
Currently the Cold Chain begins with electricity-fed refrigerated transportation vehicles or containers.
However, the farther along the chain you go, the more difficult it is to maintain. Keeping a valid Cold
Chain in an electrically refrigerated cargo transport plane is easy; doing the same during a multi-day trip
made by bicycle or donkey is an entirely different challenge level. Additionally there is a high probability
of long layovers at unrefrigerated intermediate depots.
A second major problem is the weight and bulk of the vaccine transportation device. Firstly there is
significant cost to transportation; this cost is strongly correlated with the weight and bulk of the cargo.
Secondly some of the key transportation modes used near the end of the Cold Chain--bicycles, walking,
donkey, etc.--rule out vaccine transportation devices such as full sized-refrigerators.
As part of the Decade of Vaccines the WHO has posted the following design challenge.
Design a vaccine transportation device given the following design criteria. You are not responsible for
the design of the entire Cold Chain.

The design cannot change the existing primary vaccine packaging. These 30 cm x 30 cm x 30 cm
boxes are sealed and the interior monitored by temperature sensitive labels to track vaccine
viability. This packaging cannot be opened.
The primary vaccine packaging box is made of cardboard and the vials are glass.

APS111&113 - 2014 Client Statement

The design must maintain a temperature range of 2C to 8C at the primary vaccine packing box
for at least 12 hours with an average solar radiation exposure of 300 W/m^2 and an ambient
temperature of 35C to 40C.
The design must be portable using the widest possible range of transportation methods. The
cold chain may utilize a large number of different transportation vehicles ranging from trucks to
bicycles, donkey or even no vehicle (pedestrian travel). Keep the design as light as possible and
minimize the bulkiness to facilitate carrying and packing.
These vaccines are transported by both highly trained medical professionals and individuals with
no medical training.

If active refrigeration is utilized, either of the following equipment may be used with no additional
monetary cost. The WHO has received a large donation of both of these models.

Laird Outdoor Thermoelectric Cooler Assembly (model AA-250-48-44-00-XX) [5]

Whynter 65 Quart Portable Fridge / Freezer (model FM-65G) [6]

Client:

Dr. Edward Jenner

World Health Organization - Family, Women's and Children's Health (FWC)
Immunization, Vaccines and Biologicals (IVB)
Ed.Jenner@who.int

Warning: This is a fictitious project. Do not contact the client. They will not know what you
are talking about.
References
[1] World Health Organization. (2013). Global vaccination action plan [Online]. Available:
http://www.who.int/iris/bitstream/10665/78141/1/9789241504980_eng.pdf?ua=1
[2] World Health Organization. (2001, October). WHO fact sheet on smallpox [Online]. Available:
http://www2.cdc.gov/nip/isd/spoxclincian/contents/references/factsheet.pdf
[3] World Health Organization. (2006, August). Temperature sensitivity of vaccines [Online].
Available: http://whqlibdoc.who.int/hq/2006/WHO_IVB_06.10_eng.pdf
[4] Logistics Cluster. (n.d.). Cold chain [Online]. Available:
http://log.logcluster.org/response/cold-chain/index.html
[5] Laird Technologies Inc. (2012). Outdoor thermoelectric cooler assemblies AA-250-48-4400-XX [Online]. Available:
http://www.lairdtech.com/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=2147486929
[6] Whynter Inc. (2014). Whynter Quart Portable Fridge/Freezer [Online]. Available:
http://www.whynter.com/productdetail/refrigeration/portable_freezers/308